There are many types and classes of braces and other orthopedic devices for fixating and immobilizing patient's limbs. Specifically in the field of foot and ankle surgery and recovery, there are multiple types of options for a care giver to stabilize a patient's foot after surgery. These braces include complicated bone fixators that have transfixation wires or pins or screws that extend into and through bone segments in order to stabilize them. Other external braces including a wide range of removable casts and ankle braces are also known.
One class of procedures was originally developed by a surgeon Dr. Ilizarov that includes the use of thin wire external fixators to move segments of bone for purposes of reconstruction of fractured or deformed extremities during orthopedic surgery. Frames used in these types of procedures are arranged crosswise in pairs or individually in each ring or ring-section level, whereby the various rings are connected to each other by means of rods and bolts, and the intervals of the ring levels are adjusted by rods of different lengths, by rods whose lengths can be varied telescopically, or by bolts that can be adjusted. A basic principle of the hybrid frames used in these types of procedures is that they may move portions of the anatomic skeleton of a patient by virtue of distraction or compression. These hybrid-type frames are now frequently in use for orthopedic applications including, but not limited to, limb lengthening, stabilization and positioning of open fractures, and in the structural correction of a multitude of lower extremity deformities including, but not limited to, correction of angulation, rotation and translation. In each case, there is use of a footplate that places wires across different segments of a patient's foot (hindfoot, midfoot, and forefoot) that are then used to distract or compress the segments of the foot for structural realignment. (There are in fact many types of procedures that may use these types of apparatuses.) In each of these systems, this footplate is connected to a ring (one or more rings) around the lower leg of the patient for stability and spatial relation with respect to the foot. If the patient's foot plate was used by itself, the patient's foot could articulate at the ankle joint, and there would be no stability at the ankle joint. Much of the intended correction could inherently then be lost and the patient would have an unsatisfactory way to hold the foot in a therapeutically correct position. Accordingly, one or two rings or partial rings are placed around the lower leg or ankle, and the foot plate is connected to the leg to hold all the structures in an anatomically rigid position ideal for healing. Additionally, rigidly stabilizing the foot plate with respect to the ankle permits early ambulation in major foot reconstructive surgery.
Medical risks associated with these Ilizarov-type procedures and associated apparatuses include the requirement of pins or wires or screws connected to the tibia and fibula, thereby presenting the possibility of infection, fracture and nerve or vessel damage in the lower leg. Use of these frames are also inherently far more complicated with respect to care and recovery. Finally, use of these hybrid frames requires a lengthy and difficult surgery that requires specialized training.
Another general type of orthopedic device that may be used as a therapeutic or surgical recovery brace is commonly know as a cam boot. This type of boot is a functional splint or cast which holds the foot in a neutral position while healing takes place after a surgery. A cam boot is noninvasive and successfully can immobilize the extremity during the healing process. Also, cam boots are removable and have a distinct hygiene advantage over predecessor casts. While appropriate in many situations and for multiple types of surgeries, a cam boot is not an option when performing surgeries to correct many foot deformities.